Case Report: Long-Acting Oral Cariprazine
IntroductionCariprazine is a third-generation antipsychotic, approved for the treatment of schizophrenia and bipolar disorder and used off-label for schizoaffective disorder and treatment-resistant depression. Cariprazine is a partial agonist at dopamine receptors D2 and D3 and serotonin receptor 5H...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.876003/full |
| _version_ | 1828349634588704768 |
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| author | Emanuela Dyrmishi Marco De Pieri Marco De Pieri Marco Ferrari Rafael Traber Matteo Preve Luca De Peri Emilio Bolla |
| author_facet | Emanuela Dyrmishi Marco De Pieri Marco De Pieri Marco Ferrari Rafael Traber Matteo Preve Luca De Peri Emilio Bolla |
| author_sort | Emanuela Dyrmishi |
| collection | DOAJ |
| description | IntroductionCariprazine is a third-generation antipsychotic, approved for the treatment of schizophrenia and bipolar disorder and used off-label for schizoaffective disorder and treatment-resistant depression. Cariprazine is a partial agonist at dopamine receptors D2 and D3 and serotonin receptor 5HT1A and an antagonist at serotonin receptors 5HT2B and 5HT2A. It is metabolized by CYP3A4 in desmetyl-cariprazine and didesmethyl-cariprazine, both active metabolites with a half-life of 1–2 days and 2–3 weeks, respectively.Case ReportHere we show the cases of 3 outpatients diagnosed with bipolar I disorder (two patients) and schizoaffective disorder (one patients) and characterized by low adherence to treatment, satisfactory cognitive and personal functioning and average disease severity to whom we administered cariprazine as a monotherapy, on a two-times a week schedule (i.e., every 72–96 h). We evaluated response to treatment and disease remission according to conventional definitions, using rating scales BPRS, PANSS and BDI-II. Two-times a week treatment was set either after a disease relapse (one patient), after a sustained remission obtained with daily administration of cariprazine (one patient) or since our first evaluation (one patient). After 4 weeks of treatment all three patients satisfied criteria for response to treatment and remission, a result that was sustained for 8 (in one patients) and 12 months (in other two patients) and still ongoing.DiscussionReported results support our hypothesis that long half-lives of cariprazine and its metabolites provide an adequate therapeutic response with a two-times a week administration. In selected patients, cariprazine administered as a “oral long-acting” seems effective in treating acute episodes of illness and in sustaining remission, combining advantages of oral and long-acting injectable antipsychotics concerning therapeutic alliance. |
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| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-14T01:13:23Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-c9dd4af091284b16a1eb7b776274f66b2022-12-22T02:20:58ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-04-011310.3389/fpsyt.2022.876003876003Case Report: Long-Acting Oral CariprazineEmanuela Dyrmishi0Marco De Pieri1Marco De Pieri2Marco Ferrari3Rafael Traber4Matteo Preve5Luca De Peri6Emilio Bolla7Organizzazione Sociopsichiatrica Cantonale, Mendrisio, SwitzerlandPhD Program in Clinical and Experimental Medicine and Medical Humanities, University of Insubria, Varese, ItalyCenter for Research in Medical Pharmacology, Varese, ItalyCenter for Research in Medical Pharmacology, Varese, ItalyOrganizzazione Sociopsichiatrica Cantonale, Mendrisio, SwitzerlandOrganizzazione Sociopsichiatrica Cantonale, Mendrisio, SwitzerlandOrganizzazione Sociopsichiatrica Cantonale, Mendrisio, SwitzerlandOrganizzazione Sociopsichiatrica Cantonale, Mendrisio, SwitzerlandIntroductionCariprazine is a third-generation antipsychotic, approved for the treatment of schizophrenia and bipolar disorder and used off-label for schizoaffective disorder and treatment-resistant depression. Cariprazine is a partial agonist at dopamine receptors D2 and D3 and serotonin receptor 5HT1A and an antagonist at serotonin receptors 5HT2B and 5HT2A. It is metabolized by CYP3A4 in desmetyl-cariprazine and didesmethyl-cariprazine, both active metabolites with a half-life of 1–2 days and 2–3 weeks, respectively.Case ReportHere we show the cases of 3 outpatients diagnosed with bipolar I disorder (two patients) and schizoaffective disorder (one patients) and characterized by low adherence to treatment, satisfactory cognitive and personal functioning and average disease severity to whom we administered cariprazine as a monotherapy, on a two-times a week schedule (i.e., every 72–96 h). We evaluated response to treatment and disease remission according to conventional definitions, using rating scales BPRS, PANSS and BDI-II. Two-times a week treatment was set either after a disease relapse (one patient), after a sustained remission obtained with daily administration of cariprazine (one patient) or since our first evaluation (one patient). After 4 weeks of treatment all three patients satisfied criteria for response to treatment and remission, a result that was sustained for 8 (in one patients) and 12 months (in other two patients) and still ongoing.DiscussionReported results support our hypothesis that long half-lives of cariprazine and its metabolites provide an adequate therapeutic response with a two-times a week administration. In selected patients, cariprazine administered as a “oral long-acting” seems effective in treating acute episodes of illness and in sustaining remission, combining advantages of oral and long-acting injectable antipsychotics concerning therapeutic alliance.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.876003/fulllong acting antipsychoticscariprazinetherapeutic alliancepersonalized medicineadherence–compliance–persistence |
| spellingShingle | Emanuela Dyrmishi Marco De Pieri Marco De Pieri Marco Ferrari Rafael Traber Matteo Preve Luca De Peri Emilio Bolla Case Report: Long-Acting Oral Cariprazine Frontiers in Psychiatry long acting antipsychotics cariprazine therapeutic alliance personalized medicine adherence–compliance–persistence |
| title | Case Report: Long-Acting Oral Cariprazine |
| title_full | Case Report: Long-Acting Oral Cariprazine |
| title_fullStr | Case Report: Long-Acting Oral Cariprazine |
| title_full_unstemmed | Case Report: Long-Acting Oral Cariprazine |
| title_short | Case Report: Long-Acting Oral Cariprazine |
| title_sort | case report long acting oral cariprazine |
| topic | long acting antipsychotics cariprazine therapeutic alliance personalized medicine adherence–compliance–persistence |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.876003/full |
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